CARDIOMETABOLIC multimorbidity emerged as a major long-term risk among older adults with depression and low physical activity, according to a new longitudinal study from China.
Cardiometabolic multimorbidity, defined as the coexistence of two or more conditions such as diabetes, stroke, or heart disease, represents a growing global health challenge.
Both depression and physical inactivity have been independently linked to these disorders, but their combined impact has remained unclear – until now.
Cardiometabolic Multimorbidity Risk Elevated by Dual Burden
The prospective cohort study followed 2,661 adults aged ≥45 years for a median of 9 years. All participants were free of cardiometabolic multimorbidity at baseline, yet 797 cases developed during follow-up.
Researchers found that individuals with both depression and no engagement in vigorous physical activity (VPA) faced the highest risk of cardiometabolic multimorbidity (hazard ratio [HR]: 1.93; 95% confidence interval [CI]: 1.52–2.44). Notably, even those with depression who engaged in VPA remained at elevated risk (HR: 1.84; 95% CI: 1.41–2.39), while physically inactive individuals without depression also showed increased risk (HR: 1.52; 95% CI: 1.22–1.89).
A clear dose–response relationship was observed, with cardiometabolic multimorbidity risk rising progressively across worsening combinations of mental health and activity levels.
Physical Activity Partially Offsets Cardiometabolic Multimorbidity
Encouragingly, the findings suggested that VPA may partially mitigate the heightened cardiometabolic multimorbidity risk associated with depression. While it did not eliminate risk entirely, active individuals consistently fared better than their inactive counterparts.
Importantly, the relationship remained stable across different metabolic health profiles, including measures such as insulin resistance and central obesity. No significant interaction was found between depression and VPA, indicating that both factors independently contribute to cardiometabolic multimorbidity development.
Implications for Prevention Strategies
These findings highlight the need for integrated prevention strategies targeting both mental health and lifestyle behaviours. Cardiometabolic multimorbidity is notoriously difficult to manage once established, making early intervention critical.
The authors acknowledged limitations, including reliance on observational data and potential residual confounding. Despite this, the consistency of results across multiple sensitivity analyses strengthens confidence in the findings.
Overall, the study underscored a key message: addressing depression alongside promoting physical activity could play a crucial role in reducing the growing burden of cardiometabolic multimorbidity in ageing populations.
Reference
Liu Z et al. Joint association of depression and physical activity with incident cardiometabolic multimorbidity (CMM) among middle-aged and older adults in China. Sci Rep. 2026;DOI:10.1038/s41598-026-50014-2.
Featured image: Rawpixel.com on Adobe Stock
